| NPI | 1093937583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE MARCHESE Insurance Coordinator 856-691-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 18248) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2012-11-13 |